The burden of diseases and risk factors in Bangladesh, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
Authors: Sheikh Mohammed Shariful Islam, Riaz Uddin, Subasish Das, Syed Imran Ahmed, Sojib Bin Zaman, Sheikh Mohammad Alif, Md Tanvir Hossen, Malabika Sarker, George Siopis, Katherine M Livingstone, Max L Mehlman, Md. Marufur Rahman, Rahat I. Chowdhury, Md. Abdul Alim, Sohel Reza Choudhury, Syed Masud Ahmed, Ripon Kumar Adhikary, Afifa Anjum, Palash Chandra Banik, Fazle Rabbi Chowdhury, Md Omar Faruk, Rajat Das Gupta, Md Abdul Hannan, Md Nuruzzaman Haque, Syed Emdadul Haque, M Tasdik Hasan, Md Belal Hossain, Md Mahbub Hossain, Muttaquina Hossain, Sahadat Hossain, Sheikh Jamal Hossain, M Nuruzzaman Khan, Md Jobair Khan, Mohammed A Mamun, Ali H Mokdad, Mohammad Ali Moni, Christopher J L Murray, Mahfuzar Rahman, Md Mosfequr Rahman, Mosiur Rahman, Zubair Ahmed Ratan, Rezaul Karim Ripon, KM Saif-Ur-Rahman, Abu Sayeed, Md Shahjahan Siraj, Saima Sultana, Ralph Maddison, Simon I Hay, Mohsen Naghavi
Journal: The Lancet Global Health (2023)

BackgroundBangladesh has made substantial progress in improving socioeconomic and health indicators over the past 50 years, but data on national disease burden are scarce. We used data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to estimate the burden of diseases and risk factors in Bangladesh from 1990 to 2019.MethodsFor this systematic analysis, we analysed data from vital registration systems, surveys, and censuses using multistage modelling processes to estimate life expectancy at birth, mortality rate, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs). Additionally, we compared the health status of Bangladesh with that of the other countries in the GBD south Asia region—Bhutan, India, Nepal, and Pakistan.FindingsLife expectancy at birth in Bangladesh increased from 58·2 years (95% uncertainty interval 57·1–59·2) in 1990 to 74·6 years (72·4–76·7) in 2019. Between 1990 and 2019, the age-standardised mortality rate decreased from 1509·3 (1428·6–1592·1) to 714·4 (604·9–838·2) deaths per 100 000 population. In 2019, non-communicable diseases represented 14 of the top 20 causes of death; the leading three causes were stroke, ischaemic heart disease, and chronic obstructive pulmonary disease. High blood pressure, high fasting plasma glucose, and smoking were the top three risk factors. From 1990 to 2019, the rate of all-cause DALYs decreased by 54·9% (48·8–60·4). In 2019, the leading causes of DALYs and YLLs were neonatal disorders, stroke, and ischaemic heart disease, whereas musculoskeletal disorders, depressive disorders, and low back pain were the leading causes of YLDs. Bangladesh has the lowest age-standardised rates of mortality, YLDs, and YLLs and the highest life expectancy at birth in south Asia.InterpretationOver the past 30 years, mortality rates have reduced by more than half in Bangladesh. Bangladesh must now address the double burden of communicable and non-communicable diseases. Cost-effective, multisectoral efforts are needed to prevent and control non-communicable diseases, promote healthy lifestyles, and prevent premature mortality and disabilities.FundingBill & Melinda Gates Foundation.TranslationFor the Bangla translation of the abstract see Supplementary Materials section.